Bacterial pathogens produce a variety of exotoxins, which often become associated with the bacterial outer membrane component lipopolysaccharide (LPS) during their secretion. LPS is a potent proinflammatory mediator; however, it is not known whether LPS contributes to cell signaling induced by those microbial components to which it is attached. This is partly due to the common view that LPS present in bacterial component preparations is an experimental artifact. The Escherichia coli exotoxin hemolysin (Hly) is a known inducer of proinflammatory signaling in epithelial cells, and the signal transduction pathway involves fluctuation of the intracellular-Ca 2؉ concentration. Since LPS is known to interact with Hly, we investigated whether it is required as a cofactor for the activity of Hly. We found that the LPS/Hly complex exploits the CD14/LPSbinding protein recognition system to bring Hly to the cell membrane, where intracellular-Ca 2؉ signaling is initiated via specific activation of the small GTPase RhoA. Hly-induced Ca 2؉ signaling was found to occur independently of the LPS receptor TLR4, suggesting that the role of LPS/CD14 is to deliver Hly to the cell membrane. In contrast, the cytolytic effect triggered by exposure of cells to high Hly concentrations occurs independently of LPS/CD14. Collectively, our data reveal a novel molecular mechanism for toxin delivery in bacterial pathogenesis, where LPS-associated microbial compounds are targeted to the host cell membrane as a consequence of their association with LPS.The exotoxin hemolysin (Hly) produced by uropathogenic Escherichia coli (UPEC) is an important virulence factor in extraintestinal infections, such as urinary tract infections, newborn meningitis, bacteremia, and septicemia (33). Hly exerts a cytolytic effect when present in high concentrations, while low, sublytic concentrations have been demonstrated to induce intracellular-Ca 2ϩ signaling in epithelial cells, leading to proinflammatory responses, such as production of interleukin-6 (IL-6) and . Hly is secreted from bacteria via the type I secretion pathway (26) and is found associated with bacterial outer membranes, in supernatants, and in outer membrane vesicles (5, 34). Hly forms high-molecular-weight complexes with lipopolysaccharide (LPS), and this interaction has been suggested to prevent aggregation and degradation of Hly as well as to promote an active conformation of the toxin (6, 12, 15). Whether there is also a molecular function of LPS in the Ca 2ϩ signaling and cytolytic activities of Hly remains unknown. Detailed information regarding the signal transduction pathway elicited by LPS does exist, however. LPS is a large amphipathic molecule composed of the acylated, hydrophobic lipid A component, the LPS core, and the O-antigen polysaccharide. Host recognition of LPS is a multistep process initiated by the binding of LPS by the LPS-binding protein (LBP). This interaction enhances the binding of LPS to the glycosylphosphatidylinositol-linked receptor CD14, whose protein structure conta...